osteonecrosis

Q:I have been diagnosed as having Osteonecrosis of the right hip. I was suggested to go in for Muscular Pedicle Bone grafting of the right femoral head. Also I was told I might have it in other joints with long bones (shoulder, knees, etc). Is there any medication, for this or is an operation essential?

A:AVN or osteonecrosis of hip cannot be treated by medication. Unfortunately surgery is only the intervention. There can be several reasons for AVN of the hip - steroids, alcohol, blood coagulopathy, radiation etc. Sometimes its difficult to find a cause. AVN of other bones is possible, but hip is the commonest and most of the time the only joint affected.I am not sure about the long term results of muscle pedicle grafting. Total hip arthoroplasty have been tried and has encouraging results but again long-standing results may not be that encouraging.It depends on the cause and the stage of the disease. also if only one hip is affected, it is better to screen for the other hip by MRI to detect any early changes.